ArticlePloS one2021
Changes in food pricing and availability on the Navajo Nation following a 2% tax on unhealthy foods: The Healthy Diné Nation Act of 2014.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
12 citing papers in PubMed.
- Challenges and Practices in Perishable Food Supply Chain Management in Remote Indigenous Communities: A Scoping Review and Conceptual Framework for Enhancing Food Access.International journal of environmental research and public health · 2026Article
- Comorbidities among American Indian and Alaska Native People with Cancer: A Surveillance, Epidemiology, and End Results-Medicare Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- A Cross-Sectional Study of Dietary Patterns andNutrition and cancer · 2025Article
- An Inventory of Proposed and Enacted Sugar-Sweetened Beverage Policies at the State, Local, and Tribal Levels in the United States, 2014‒2023.American journal of public health · 2024Article
- Effectiveness of implemented global dietary interventions: a scoping review of fiscal policies.BMC public health · 2024Article
- Improving economic access to healthy diets in first nations communities in high-income, colonised countries: a systematic scoping review.Nutrition journal · 2024Article
- Cardiovascular Disease Burden and Outcomes Among American Indian and Alaska Native Medicare Beneficiaries.JAMA network open · 2023Article
- Practicing Tribal Sovereignty Through a Tribal Health Policy: Implementation of the Healthy Diné Nation Act on the Navajo Nation.Preventing chronic disease · 2022Article
- Implementation of Indigenous Food Tax Policies in Stores on Navajo Nation.Health promotion practice · 2022Article
- Navajo Nation Stores Show Resilience During COVID-19 Pandemic.Health promotion practice · 2022Article
- Driving Distance and Food Accessibility: A Geospatial Analysis of the Food Environment in the Navajo Nation and Border Towns.Frontiers in nutrition · 2022Article
- The Navajo Nation Healthy Diné Nation Act: Community Support of a 2% Tax on Unhealthy Foods.Journal of public health management and practice : JPHMPArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
introductionIn 2014, the Navajo Nation Healthy Diné Nation Act (HDNA) was passed, combining a 2% tax on foods of 'minimal-to-no-nutritional value' and waiver of 5% sales tax on healthy foods, the first-ever such tax in the U.S. and globally among a sovereign tribal nation. The aim of this study was to measure changes in pricing and food availability in stores on the Navajo Nation following the implementation of the HDNA.
methodsStore observations were conducted in 2013 and 2019 using the Nutrition Environment Measurement Survey-Stores (NEMS-S) adapted for the Navajo Nation. Observations included store location, type, whether healthy foods or HDNA were promoted, and availability and pricing of fresh fruits and vegetables, canned items, beverages, water, snacks and traditional foods. Differences between 2013 and 2019 and by store type and location were tested.
resultsThe matched sample included 71 stores (51 in the Navajo Nation and 20 in border towns). In 2019, fresh produce was available in the majority of Navajo stores, with 71% selling at least 3 types of fruit and 65% selling at least 3 types of vegetables. Compared with border town convenience stores, Navajo convenience stores had greater availability of fresh vegetables and comparable availability of fresh fruit in 2019. The average cost per item of fresh fruit decreased by 13% in Navajo stores (from $0.88 to $0.76) and increased in border stores (from $0.63 to $0.73), resulting in comparable prices in Navajo and border stores in 2019. While more Navajo stores offered mutton, blue corn and wild plants in 2019 compared to 2013, these changes were not statistically significant. DISCUSSION: The findings suggest modest improvements in the Navajo store environment and high availability of fruits and vegetables. Navajo stores play an important role in the local food system and provide access to local, healthy foods for individuals living in this rural, tribal community.
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